Stage-dependent depression of melatonin in patients with primary breast cancer. Correlation with prolactin, thyroid stimulating hormone, and steroid receptors
✍ Scribed by Christian Bartsch; Hella Bartsch; Ute Fuchs; Theodor H. Lippert; Otto Bellmann; Derek Gupta
- Publisher
- John Wiley and Sons
- Year
- 1989
- Tongue
- English
- Weight
- 816 KB
- Volume
- 64
- Category
- Article
- ISSN
- 0008-543X
No coin nor oath required. For personal study only.
✦ Synopsis
Serum melatonin was determined over 24 hours in 35 patients with breast cancer with either a fresh primary tumor (n = 23) or a secondary tumor (n = 12) and in 28 patients with untreated benign breast disease (controls) having a fibroadenoma (n = lo), fibrocystic mastopathy (n = 14), or other breast diseases (n = 4). Circadian rhythms existed in all groups with acrophases at 2 a.m. A 50% depression of peak and amplitude occurred in the group of patients with primary breast cancer compared with agematched controls (P < 0.001, P < 0.01). The peak declined with increasing tumor size: 27% at Stage TI, 53% at T2 (P < 0.001), and 73% at T3 (P < 0.05). In contrast, patients with secondary breast cancer, particularly those receiving antiestrogen therapy, had a melatonin peak similar to controls. These results demonstrated a transient depression of pineal melatonin secretion in primary breast cancer and indicated a dynamic role of the pineal gland in malignancy. To investigate some endocrine effects of a depressed melatonin peak, the 24-hour rhythms of prolactin (PRL) and thyroid stimulating hormone (TSH) were determined in patients with primary breast cancer and compared with patients with secondary breast cancer. The PRL had significant circadian rhythms in both groups; but acrophases occurred at midnight in patients with secondary breast cancer, and there were unusually high concentrations at noon in patients with primary breast cancer. Circadian rhythms were not seen for TSH, but the 24-hour average secretion was depressed by 45% (P < 0.01) in patients with primary breast cancer. The abnormal concentrations of PRL and TSH in these patients could be due to a depressed melatonin peak normally serving as a central circadian synchronizer and modulator of the secretion of adenohypophysial hormones. Additionally, a positive correlation existed between the nocturnal melatonin peak and progesterone and androgen receptor concentrations in primary tumors indicating a direct involvement of melatonin in the growth control of breast cancer.
Cancer 64:426-433, 1989.
VIDENCE for an involvement of the pineal hormone, E melatonin, in breast cancer stems from experimental and clinical studies. 's2 The 7,12-dimethyl-benz(a)anthracene (DMBA)-induced mammary tumors in the female rat are inhibited by exogenous melat~nin,~ and melatonin excretion and secretion are modified in human breast cancer (BC) patients. Bartsch et aL4 observed that the urinary excretion of melatonin is depressed and modified in postmenopausal patients with primary BC. Ta-From the *